376628564-3-21-2022-20-CC-LGAO-CCQRVR-20220321132157

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 376628564
Report Date: 03/21/2022
Date Signed: 03/21/2022 01:22:09 PM

Document Has Been Signed on 03/21/2022 01:22 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME:	MARTINEZ, ABIGAIN FAMILY CHILD CARE		FACILITY NUMBER:	376628564
ADMINISTRATOR:	ABIGAIN MARTINEZ		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(619) 770-1986
CITY:	SAN DIEGO	STATE: CA	ZIP CODE:	92105
CAPACITY:	14	CENSUS: 3	DATE:	03/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Abigain Martinez		TIME COMPLETED:	01:30 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On March 21, 2022, at 10:00 AM, Licensing Program Analyst (LPA), Luigi Gargaro, conducted an unannounced annual required inspection and met with the licensee, Abigain Martinez. LPA disclosed the purpose of the inspection and was granted entry into the facility by the Licensee. Three (3) children and the licensee were present in the facility during this inspection. This facility is a one floor, three bedroom, two bathroom home. Licensee accompanied LPA inside the facility during this inspection. The following areas used for child care are: the two day care rooms and the day care bathroom. Off limits areas are the kitchen, the three home bedrooms, the second bathroom and the home garage. The kitchen is made off limits with a secured child safety gate that is installed in the entrance way between the living room and the kitchen. The first two home bedrooms are made off limits with a door knob cover and a locking door handle respectively. The third (master) bedroom and second bath are located behind the kitchen and are made off limits by the use of the kitchen safety gate. The garage is detached from the home and is otherwise inaccessible as it is in the off limits yard area. The licensee does have an operable wall heating unit but attests that it is not be used during day care hours and understands that if she decides to operate it in the day care, prior to its use, she must install a gate or other safety device around it to make it inaccessible to children in care. Licensee previously submitted a signed written declaration attesting to same. The fire extinguisher, smoke detector, and carbon monoxide detector met requirements. All hazardous items were inaccessible to children. The licensee has toys, play equipment and materials available. The home has a fenced front yard available for outdoor activities. The home has a side yard and drive way that licensee states are off limits to the day care as they are not appropriate care areas. No bodies of water observed on the premises during the inspection. Licensee stated there are no weapons in the home. A review of staff records on this date indicates that all facility staff or other individuals who require caregiver background checks have received criminal record and child abuse clearances or exemptions.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 03/21/2022 01:22 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MARTINEZ, ABIGAIN FAMILY CHILD CARE	FACILITY NUMBER: 376628564
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/21/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

102425(j)(2)(D)(c)

Infant Safe Sleep

Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: Time of each 15-minute check This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above as during inspection analyst found that licensee was not maintaining a safe sleep log which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 03/28/2022
	Plan of Correction
1 2 3 4	Licensee stated she was unaware of this part of the infant safe sleep regulations but will start maintaining a safe sleep log immediately. Analyst provided licensee with a copy of the safe sleep regulations and a sample safe sleep log during today's visit. Licensee states she will begin documenting her infant's nap times from this point forward and submit a copy of a completed log for her children from 03/22/22-03/25/22 on 03/28/22 to complete the correction.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 7575 METROPOLITAN DR., STE 110
SAN DIEGO, CA 92108

FACILITY NAME: MARTINEZ, ABIGAIN FAMILY CHILD CARE	FACILITY NUMBER: 376628564
	VISIT DATE: 03/21/2022

NARRATIVE

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Licensee’s First Aid and CPR certifications expire on 10/02/23. Licensee has required immunizations. Licensee completed Mandated Reporter Training on 07/06/20. Facility roster is maintained and was reviewed. The last fire and disaster drills were conducted and documented on 12/23/21. There is one crib or play yard for each infant who is unable to climb out of the crib or play yard. Cribs or play yards are free from all loose articles and objects. An Individual Infant Sleeping Plan [LIC 9227 (3/20)] is maintained for each infant up to 12 months of age. The provider places infants up to 12 months of age on their backs for sleeping.

LPA provided and discussed the following: Report suspected child abuse and neglect, maintain children’s records according to regulation, post all required forms, and ensure that all adults residing or working in the home have criminal background clearances or exemptions. Licensee was reminded that corporal punishment, smoking, exersaucers, bouncy seats, walkers, and jumpers and/or similar equipment are not allowed in daycare. Licensee was also provided handouts with information regarding upcoming Safe Sleep Regulations/SIDS, Lead exposure and Shaken Baby Syndrome. LPA and Licensee discussed California Megan's Law and LPA provided: www.meganslaw.ca.gov.

LPA discussed and provided Licensee with the following: child care advocates email address: childcareadvocatesprogram@dss.ca.gov . In addition, for general questions or questions regarding licensing requirements contact the Child Care Licensing Duty Line at (619) 767-2248.

Incidental Medical services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm.

One type B violation California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 809-D.

An exit interview was conducted with the licensee. The licensee was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights.

LPA provided notice of site visit and observed it being posted at the facility.

SUPERVISOR'S NAME: Jason Garay	TELEPHONE: (619) 767-2250
LICENSING EVALUATOR NAME: Luigi Gargaro	TELEPHONE: (619) 767-2229
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2022

LIC809 (FAS) - (06/04)

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